Provider Demographics
NPI:1902293558
Name:LINGAMFELTER, MAX (DO)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:LINGAMFELTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 LINDEN DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6900
Mailing Address - Country:US
Mailing Address - Phone:540-678-3588
Mailing Address - Fax:
Practice Address - Street 1:128 MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3322
Practice Address - Country:US
Practice Address - Phone:540-667-8975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0102206631207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program